longitudinal relaxing incision as a technique for recurrence prevention in ventral hernia

Conditions: Ventral Hernia

Summary: the aim of the study is showing the efficiency of using longitudinal relaxing incision as a technique for recurrence prevention in ventral hernia

ventral hernias of the abdomen are defined as a non-inguinal, nonhiatal defect in the fascia of the abdominal wall. annually, there are about 350,000 ventral hernia operations. the repair of these abdominal wall defects is a common surgery performed by general surgeons. surgery is typically recommended for individuals with acceptable operative risk, symptomatic hernias, or those at elevated risk of developing complications from a hernia. they can affect an individual's quality of life and can lead to hospitalizations and even death in some cases etiologies of a ventral hernia can be broken down into 2 main categories; acquired or congenital. the vast majority of hernias that general surgeons see and treat are acquired; however, some individuals live with their ventral hernias from birth for prolonged periods of time before having them surgically repaired. common causes of acquired ventral hernias include previous surgery causing an incisional hernia, trauma, and repetitive stress on naturally weak points of the abdominal wall. these naturally occurring weak points in the abdominal wall include the umbilicus, semilunar line, ostomy sites, bilateral inguinal regions, and esophageal hiatus. obesity is a large component of hernias as well because it stretches the fascia of the abdomen causing it to weaken. specifically, the action of repetitive weight gain and loss leads to weakening the most common treatment of ventral hernias includes surgery. asymptomatic hernias are repaired on an elective basis, but those presenting with strangulation require immediate surgery. incarceration without strangulation is not a surgical emergency; however, the risks and benefits of surgery should be discussed with the patient, and a patient with reasonable operative risk should have their hernia repaired within a sensible time frame. non-surgical management of abdominal wall hernias with the use of binders, trusses, or corsets is not considered to be effective. however, this may be the only option in a patient who is not a reasonable candidate for surgery over the years, many types of surgical techniques have been developed to repair hernias. there are many tenants of hernia repair. the most important being a tension-free closure, but others include the use of a mesh with 3 to 5 cm of overlap, meticulous handling of the mesh, preventing surgical site infections, and using a sublay technique with the closure of the fascia if possible. the most basic approach is a primary open repair without mesh, which should typically be reserved for defects in the fascia of less than 2 cm. an open repair with mesh has several options including what type of mesh and where to place the mesh. hernia recurrence is an extremely important postoperative outcome and assesses surgical efficacy. the ability to predict recurrence accurately would have considerable clinical utility, allowing surgeons to make better-informed decisions with their patients as to when and when not, to operate. multiple associated conditions, such as obesity, smoking, and others, have been reported in various studies to contribute to higher recurrence rates.

Eligibility criteria:
inclusion criteria: * any patient with ventral hernia admitted at assiut university hospital exclusion criteria: * recurrent hernia * complicated \[obstructed \& strangulated\]